Individual
GARRETT L. WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20380 TOWN CENTER LN, SUITE 215, CUPERTINO, CA 95014-3210
(408) 996-7950
(408) 996-7997
Mailing address
20380 TOWN CENTER LN, SUITE 215, CUPERTINO, CA 95014-3210
(408) 996-7950
(408) 996-7997
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A74445
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A744450
—
CA
Enumeration date
10/27/2006
Last updated
07/12/2012
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